Lack of resources and social stigma continue to stand in the way of saving lives of those at risk of AIDS in many parts of Africa.
GAROUA — A group of women, some of them pregnant, others with babies in their arms, are gathered in front of a health center in Garoua, in Cameroon's North Region. They're here to get tested for HIV.
Many of the women were encouraged to come by volunteers from a UNICEF-backed NGO called No Limit for Women Project, which is working to reduce the risk of HIV transmission from mothers to babies. In Cameroon, half of HIV-positive pregnant women give birth at home, and most of the time they aren't even aware of their condition and so don't receive treatment to reduce the risk of HIV transmission, according to Odette Etame, the program director.
Covered by a pink veil, Clarisse Njama leaves the center proudly waving a document confirming she's HIV-negative. It was her first medical screening. Only a little drop of blood and the results are immediate. "My husband didn't want to pay the 2,000 Central African CFA francs ($3.50) for prenatal consultation. But the volunteers told me the HIV treatments are free of charge," she says.
The World Health Organization estimates that 560,000 — 3.8% of Cameroon's 20 million inhabitants — are HIV-positive. Six years ago, the percentage was 4.3%. Experts say the improvement is due to efforts aimed at reducing transmission of the disease between mothers and their babies. Now, 87% of the women who attend prenatal consultation are tested for HIV. Nearly 10% of babies are also tested.
In theory, women and children who test positive are supposed to be given antiretroviral drugs for the rest of their lives. But as of last year, only about half the women are treated. "Medical teams are understaffed and not welcoming enough," says Theresa Nduwimana, manager of the HIV section at UNICEF's Cameroon chapter.
The hospital in Garoua, which serves a region with 2.7 million inhabitants, only has one gynecologist and one pediatrician. "This is why we're leaning more and more on NGOs. They will soon have the ability to dispense antiretroviral treatment so that women don't stop taking their medication after they stop breastfeeding," the UNICEF official adds. "But we will have to solve the problem of shortages due to logistical issues." That's a diplomatic way of referring to corruption and fraudulent resales of the life-saving medications.
In Yaoundé, the capital of Cameroun, the hospital of the Chantal Biya Foundation (named after the president's wife) is one of four healthcare centers in the country equipped with a virologic testing machine, which determines within an hour if a baby is carrying the virus when the mother is HIV-positive. "Before, we had to wait for at least four weeks to get the results," says Suzanne, a nurse. "It wasn't easy to find the mothers afterwards to inform them if they or their baby were infected."
An elegant, HIV-positive woman has come to the hospital to have her one-year-old baby tested. This is the infant's second test. "For the first screening (at six months), I was so nervous that I couldn't sleep for a month," the woman says. "Fortunately, the test just confirmed my child is not infected. What a relief!"
She explains happily that her HIV-negative husband has stayed with her despite her condition. "I am very lucky," says. "But I wish I could talk more publicly about my situation. I'm a teacher and my husband has a high-level job."
My life is ruined
Stigmatization of ill people is still a reality in Cameroon. The burden falls heaviest on women since men rarely get tested. In some Muslim communities in the north, HIV-positive women are chased from their homes.
Amina is watching on her one-year-old granddaughter. They live in a simple hut some 110 km away from Garoua. The baby receives antiretroviral treatment. She's also malnourished. "We don't have any milk to give to her," says Amina, who lost seven of her 10 children. Her 22-year-old daughter was very ill and died shortly after giving birth.
"I didn't know she was carrying the virus," Amina says. "I'm really upset with her husband, who was 36 when he took her as a second spouse. He's the one who infected her."
Forced marriage of young teenage girls with older, polygamous men remains a common practice in northern Cameroun and encourages the spread of HIV, as does prostitution.
Priscilla Yuballa started to "date guys' at a young age. At 14, she gave birth to an HIV-positive baby who only survived one week. "My older sister told everyone I was ill," she says. "Now people insult me just in the way they look at me. I sell vegetables, but my life is ruined."
In 2015, only 13% of the estimated 80,000 HIV-positive children in Cameroon received proper treatment. The country is working hard to improve things, but there's still a long way to go to bring the death rate down and soften the sting of stigmatization.